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Assistant Risk Consultant Medical – Claims
About the Job.
Achieving Zamara’s ambitious strategic priorities will be complex and challenging. Its continued success will be dependent on building and retaining a world-class team.
You will not be alone as we have other top-class Claims Consultants. At Zamara, we are passionate about the client experience so if this aligns to how you view your work, you are well on your way to being part of us.
The role will report to Team Leader Care Management Wellness and Claims.
In more detail, the areas of responsibility include:
- Claim data entry by registering (scanning/coding/indexing/batching) documentation into the system for adjudication vetting and settlement – member validity.
- Timely Logging in claim data into the system, for ease of management and reference.
- Following up for settlement of claims within agreed turnaround time.
- Provider management and training on claim processes and document facilitation.
- Reconciliation of accounts with various providers to ensure compliance to the set guidelines on credit allowance.
- Provide data reports collected from various monitoring tools assigned to the role e.g., weekly and/or monthly reports.
The following qualification is preferred:
- Diploma or undergraduate qualification in any medical course (Nursing/Clinical medicine).
- General understanding of the insurance industry is an added advantage.
- Certificate of Proficiency in Insurance will be an added advantage.
- Microsoft Office Skills.
- Good Listening Skills.
- Problem Solving Skills.
- Strong communication skills both written and verbal.
- Interpersonal Skills.
The following personal qualities are preferred:
- Ability to be resourceful and proactive in dealing with issues that may arise.
- Ability to organise, multitask, prioritise, and work under pressure.
- Excellent time management skills.
- Ability to deliver on Customer Focus.
- Ability to maintain confidentiality.
- Well-groomed and presentable.
The role will be based in Nairobi, Kenya
How To Apply
If your career aspirations match this opportunity, share your CV via LinkedIn on or before 12:00pm, Wednesday, 29 September 2021. Only shortlisted candidates will be contacted.
Any form of canvassing will lead to automatic disqualification.